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U.S. Rep. Charles Boustany Jr. is pressing federal officials for “a more vigorous education program” on Medicare not covering long-term nursing home care, saying this broad misconception puts millions of Americans’ retirement savings at risk.

“I’ve heard from several families who were blindsided to learn of Medicare coverage limits for long-term care once a loved one needed these services,” says Boustany, a Republican from Lafayette and a heart surgeon who initially practiced in Rochester, N.Y., before taking a job at Charity Hospital in New Orleans.

“More recently, dozens of constituents have contacted me with concerns about the funding cuts to home health providers and skilled nursing facilities that were passed by the House of Representatives in HR 3162.”

The congressman, supported by fellow members of the Louisiana delegation and Congress, introduced legislation and sent letters to the U.S. Department of Health and Human Resources (HHS) and Social Security Administration requesting they better inform the public about Medicare limitations. He’s also an original co-sponsor of the Long-Term Care Affordability and Security Act (HR 3363) aimed at increasing consumer protection for long-term care insurance.

Boustany and Congresswoman Stephanie Herseth-Sandlin, a Democrat from South Dakota, have introduced a resolution to declare Long-Term Care Awareness Week on Nov. 4-7. Boustany also persuaded House appropriators to push HHS to communicate Medicare limitations to the public. Sen. Mary Landrieu, a Democrat from New Orleans who secured identical language in the Senate version of the health care appropriations bill, agrees, adding, “ … the federal government has a responsibility to educate the public about what Medicare does and does not cover” and should do it more aggressively.

“Despite funding from Congress for long-term care education activities, the HHS has done little to inform families and caregivers of this confusion,” Boustany said in a floor speech on HR 133 introduced in the U.S. House of Representatives in May. “HHS has neglected to clarify these Medicare misperceptions with at least 90% of households contacted through its long-term care awareness direct mail campaign. HHS has a duty to use other communication methods to inform families.”

Thomas Kickham, director of strategic research and campaign management with the Centers for Medicare and Medicaid Services in HHS, says his group is initiating a letter campaign that will be sent by the governor of select states to households with residents 45 to 65 years old as part of the Long-Term Partnership Campaign. He says the letter will state, “Medicare does not generally pay for long-term services.”

Although Medicare covers no long-term nursing home care, Kickham says the statement is meant to draw people to their planning booklet and Web sites,longtermcare.gov and medicare.gov.

Boustany maintains the campaign has been ineffective because people have to request the information despite Congress allocating $3 million a year for five years to make Medicare limitations public knowledge.

According to AARP, an estimated 60% of Americans still believe Medicare will cover long-term nursing home care for their parents or themselves. By the time they start seeking care, however, they discover the mistake and face catastrophic costs of skilled care and/or liquidating retirement savings to qualify for Medicaid, which considerably lessens choices for care.

Kickham calls the campaign “a start” and says he shares Boustany’s concerns about people’s experiences with long-term care. But Boustany says Medicaid will bankrupt many Americans who are not properly informed. Additionally, he says state budgets will shoulder “an unsustainable burden” if Medicaid remains the default option for middle-class baby boomers who discover they need long-term care.

“This jeopardizes the nation’s retirement system as a whole so I think it’s something that needs to be made known,” he says. “This huge group may be operating under wrong assumptions with Medicare, and it’s very important to address this now before a tsunami of [baby] boomers hit and put more burdens on the state.”

At the Capital Area Agency on Aging in Baton Rouge, coordinator Jan Latimer says the Medicare misconception is a serious problem. She routinely deals with disheartened callers on the Agency’s LouisianaAnswers telephone line who have just learned Medicare won’t pay for long-term nursing home care.

“They have been counting on Medicare paying the nursing home bill and are startled and severely disappointed to learn that does not,” Latimer says. “Now they have to completely rethink their family financial planning because they have to qualify for Medicaid to pay for long-term care, if they can.”

Boustany also maintains Congress should do more to assist family caregivers, who make significant physical and emotional sacrifices while caring for a loved one. The AARP reports 44 million people now provide this unpaid care with an estimated value of up to $257 million a year.

“If nothing changes, Medicaid will remain the default payer for the millions of middle-class baby boomers who will have to impoverish themselves to qualify for long-term care services under this program,” he says. “Because of Medicaid’s institutional bias, many who seek long-term care through Medicaid find it difficult to receive care in a setting of their choice. Facilities serving a high percentage of Medicaid patients often face quality problems due to inadequate staffing levels.”

Richard L. Kaplan, a University of Illinois College of Law professor who specializes in elder law, says Congress has been basically saying, “We ain’t covering your bills,” since 1993, leaving people to pay for care themselves or buying long-term care insurance. Although Congress made it considerably more difficult to get Medicaid help last year, Kaplan predicts the federal program will “implode” with more people living longer—particularly women—and acquiring costly aging diseases like Alzheimer’s or dementia.

“For Medicaid it’s a significant problem, and for ordinary people it’s a gigantic problem,” he says. “You have a 1965 program managing people in 2007. We shouldn’t be too terribly surprised it doesn’t fit.”

Kaplan calls Medicaid “the real estate tax” because it affects substantially more people who are wiped out by long-term care costs. While the estate tax has a $2 million exemption, it’s only $2,000 for Medicaid.

“When people moan about the estate tax it affects a few Americans, but 43% of Americans over 64 will spend some time in long-term care so this is a big problem,” he says. “Medicaid is the flat tax people’s dream … there’s no exemptions for IRAs, 401Ks, municipal bonds, principal residence, etc. … unlike the tax code exemptions. Even if you get a gift, Medicaid doesn’t care. Money is money.”